ArticlePloS one2016
Resistance Pattern and Molecular Characterization of Enterotoxigenic Escherichia coli (ETEC) Strains Isolated in Bangladesh.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Prevalence of common diarrheagenic enterobacteriaceae in Iran (2000-2023): a systematic review and meta-analysis.BMC gastroenterology · 2025Pooled it
- Antimicrobial Prescribing during Infant Hospital Admissions in a Birth Cohort in Dhaka, Bangladesh.Journal of tropical pediatrics · 2021Trial
- Emerging and Underdetected Colonization Factors in EnterotoxigenicMicroorganisms · 2026Review
- Characterization of Escherichia Phage ND-4 Against Avian PathogenicLife (Basel, Switzerland) · 2026Article
- Comparison of Immunogenicity of Cood-Cotd, CfaB-st-CfaE, and Cssa-Cssb-ltb Chimeric Proteins and Their Chitosan Nanoparticles Against ETEC in an Animal Model.The protein journal · 2026Article
- Vaccine Candidates Designed to Prevent Enterotoxigenic Escherichia coli Diarrhoea: A Scoping Review of Clinical Trials Evaluating Vaccine Candidates in Development.Tropical medicine & international health : TM & IH · 2026Article
- Article
- Prevalence and Antibiotic Resistance Pattern ofInfection and drug resistance · 2026Article
- Prevalence of noncanonical virulence factors in the adherence and invasion by enterotoxigenicFrontiers in cellular and infection microbiology · 2026Article
- Genomic insights into a diarrheal outbreak in Bangladesh reveal novel ETEC lineages and expansion of CS23 colonization factor.Microbiology spectrum · 2025Article
- Surveillance of genomic diversity and antimicrobial resistance in enterotoxigenicJournal of medical microbiology · 2025Article
- Multidrug-Resistant Escherichia coli Isolated from Stool Samples of Healthy Infants in Rural Bangladeshi Communities.The American journal of tropical medicine and hygiene · 2025Article
- Epidemiology of enterotoxigenicFrontiers in microbiology · 2025Article
- Prevalence and molecular characterization of multi-resistantAnimal biotechnology · 2024Article
- Epidemiology of EnterotoxigenicMicroorganisms · 2024Article
- The Antimicrobial Resistance of EnterotoxigenicMicroorganisms · 2024Article
- Age-dependent pathogenic profiles of enterotoxigenicFrontiers in public health · 2024Article
- Knowledge, attitudes, and practices regarding antibiotic use in Bangladesh: Findings from a cross-sectional study.PloS one · 2024Article
- Article
- Virotyping and genetic antimicrobial susceptibility testing of porcine ETEC/STEC strains and associated plasmid types.Frontiers in microbiology · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnterotoxigenic Escherichia coli (ETEC) is a common cause of bacterial infection leading to acute watery diarrhea in infants and young children as well as in travellers to ETEC endemic countries. Ciprofloxacin is a broad-spectrum antimicrobial agent nowadays used for the treatment of diarrhea. This study aimed to characterize ciprofloxacin resistant ETEC strains isolated from diarrheal patients in Bangladesh.
methodsA total of 8580 stool specimens from diarrheal patients attending the icddr,b Dhaka hospital was screened for ETEC between 2005 and 2009. PCR and Ganglioside GM1- Enzyme Linked Immuno sorbent Assay (ELISA) was used for detection of Heat labile (LT) and Heat stable (ST) toxins of ETEC. Antimicrobial susceptibilities for commonly used antibiotics and the minimum inhibitory concentration (MIC) of nalidixic acid, ciprofloxacin and azithromycin were examined. DNA sequencing of representative ciprofloxacin resistant strains was performed to analyze mutations of the quinolone resistance-determining region of gyrA, gyrB, parC and parE. PCR was used for the detection of qnr, a plasmid mediated ciprofloxacin resistance gene. Clonal variations among ciprofloxacin resistant (CipR) and ciprofloxacin susceptible (CipS) strains were determined by Pulsed-field gel electrophoresis (PFGE).
resultsAmong 1067 (12%) ETEC isolates identified, 42% produced LT/ST, 28% ST and 30% LT alone. Forty nine percent (n = 523) of the ETEC strains expressed one or more of the 13 tested colonization factors (CFs) as determined by dot blot immunoassay. Antibiotic resistance of the ETEC strains was observed as follows: ampicillin 66%, azithromycin 27%, ciprofloxacin 27%, ceftriazone 13%, cotrimaxazole 46%, doxycycline 44%, erythromycin 96%, nalidixic acid 83%, norfloxacin 27%, streptomycin 48% and tetracycline 42%. Resistance to ciprofloxacin increased from 13% in 2005 to 34% in 2009. None of the strains was resistant to mecillinam. The MIC of the nalidixic acid and ciprofloxacin of representative CipR strains were 256 μg/ml and 32μg/ml respectively. A single mutation (Ser83-Leu) in gyrA was observed in the nalidixic acid resistant ETEC strains. In contrast, double mutation in gyrA (Ser83-Leu, Asp87-Asn) and a single mutation in parC (Glu84-Ly) were found in ciprofloxacin resistant strains. Mutation of gyrB was not found in either the nalidixic acid or ciprofloxacin resistant strains. None of the ciprofloxacin resistant strains was found to be positive for the qnr gene. Diverse clones were identified from all ciprofloxacin resistant strains by PFGE analysis in both CF positive and CF negative ETEC strains.
conclusionEmergence of ciprofloxacin resistant ETEC strains results in a major challenge in current treatment strategies of ETEC diarrhea.
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